Objective: The aim of this study is to evaluate the effectiveness of dry needling (DN) with fast-in and fast-out technique for myofascial
trigger points (MTrPs) in the upper trapezius muscle associated with neck pain.
Patients and Methods: Patients aged 18-70 years, who have had neck pain at least one active MTrP in the upper trapezius muscle
treated with DN, were included in the study. Pain and disability were assessed with Numeric Rating Scale (NRS) and Neck Disability
Index (NDI) before treatment (T0), after first session (T1) and after last session (T2). Number of MTrPs where DN was performed
and the number of DN sessions were recorded. Patients were evaluated based on the minimal clinically important change (MCIC)
scores for NRS and NDI.
Results: A total of 76 patients (Female: 67, Male: 9) were included in the study. Median number of DN sessions was 3 and median of
MTrPs that DN performed was 4. Both NRS and NDI showed significant improvement at T1 and T2. More than 90% of patients had
MCIC at T1 and T2.
Conclusion: Dry needling with fast-in and fast-out technique is effective for pain and disability management in patients with neck
pain due to MTrPs.
Navarro-Santana MJ, Sanchez-Infante J, Fernández-de-Las-
Peñas C, et al. Effectiveness of dry needling for myofascial
trigger points associated with neck pain symptoms: An
updated systematic review and meta-analysis. J Clin Med
2020;9: 3300. doi: 10.3390/jcm9103300
Shah JP, Thaker N, Heimur J, et al. Myofascial trigger points
then and now: a historical and scientific perspective. PM&R
2015:7: 746-61. doi: 10.1016/j.pmrj.2015.01.024
Climent JM, Kuan T-S, Fenollosa P, et al. Botulinum toxin
for the treatment of myofascial pain syndromes involving
the neck and back: a review from a clinical perspective.
Evid Based Complement Alternat Med 2013:2013.
doi: 10.1155/2013/381459
Shah JP, Danoff JV, Desai MJ, et al. Biochemicals associated
with pain and inflammation are elevated in sites near to and
remote from active myofascial trigger points. Arch Phys Med
Rehabil 2008;89: 16-23. doi: 10.1016/j.apmr.2007.10.018
Unverzagt C, Berglund K, Thomas J. Dry needling for
myofascial trigger point pain: a clinical commentary. Int J
Sports Phys Ther 2015;10: 402-18.
Fernández-de-Las-Peñas C, Nijs J. Trigger point dry needling
for the treatment of myofascial pain syndrome: current
perspectives within a pain neuroscience paradigm. J Pain Res
2019;12: 1899-1911. doi: 10.2147/JPR.S154728
Pecos-Martín D, Montañez-Aguilera FJ, Gallego-Izquierdo T,
et al. Effectiveness of dry needling on the lower trapezius in
patients with mechanical neck pain: a randomized controlled
trial. Arch Phys Med Rehabil 2015;96: 775-81. doi: 10.1016/j.
apmr.2014.12.016
Dommerholt J. Dry needling—peripheral and central
considerations. J Man Manip Ther 2011;19: 223-7.
doi: 10.1179/106698111X131.297.29552065
Dunning J, Butts R, Mourad F, et al. Dry needling:
a literature review with implications for clinical
practice guidelines. Phys Ther Rev 2014;19: 252-65.
doi: 10.1179/108331913X138.442.45102034
Tsai C-T, Hsieh L-F, Kuan T-S, et al. Remote effects of dry
needling on the irritability of the myofascial trigger point in
the upper trapezius muscle. Am J Phys Med Rehabil 2010;89:
133-40. doi: 10.1097/PHM.0b013e3181a5b1bc
Liu L, Huang Q-M, Liu Q-G, et al. Effectiveness of dry
needling for myofascial trigger points associated with neck
and shoulder pain: a systematic review and meta-analysis.
Arch Phys Med Rehabil 2015;96: 944-55. doi: 10.1016/j.
apmr.2014.12.015
Aslan E, Karaduman A, Yakut Y, et al. The cultural adaptation,
reliability and validity of neck disability index in patients with
neck pain: a Turkish version study. Spine 2008;33: E362-E365.
doi: 10.1097/BRS.0b013e31817144e1
Cleland JA, Fritz JM, Whitman JM, et al. The reliability
and construct validity of the Neck Disability Index and
patient specific functional scale in patients with cervical
radiculopathy. Spine 2006;31: 598-602. doi: 10.1097/01.
brs.000.020.1241.90914.22
Pool JJ, Ostelo RW, Hoving JL, et al. Minimal clinically
important change of the Neck Disability Index and the
Numerical Rating Scale for patients with neck pain. Spine
2007;32: 3047-51.doi: 10.1097/BRS.0b013e31815cf75b
Simons DG, Travell J, Simons LS. Myofascial pain and
dysfunction: the trigger point manual. Volume 1. Baltimore:
Williams and Wilkins, 1999.
Hong C-Z. Considerations and recommendations regarding
myofascial trigger point injection. J Musculoskelet Pain
1994;2: 29-59.doi: 10.1300/J094v02n01_03
Tekin L, Akarsu S, Durmuş O, et al. The effect of dry needling
in the treatment of myofascial pain syndrome: a randomized
double-blinded placebo-controlled trial. Clin Rheumatol
2013;32: 309-15.doi: 10.1007/s10067.012.2112-3
Onat SS, Polat CS, Bicer S, et al. Effect of dry needling injection
and kinesiotaping on pain and quality of life in patients with
mechanical neck pain. Pain physician 2019;22: 583-9.
Cagnie B, Castelein B, Pollie F, et al. Evidence for the use of
ischemic compression and dry needling in the management
of trigger points of the upper trapezius in patients with neck
pain: a systematic review. Am J Phys Med Rehabil 2015;94:
573-83.doi: 10.1097/PHM.000.000.0000000266
Cerezo-Téllez E, Torres-Lacomba M, Fuentes-Gallardo I,
et al. Effectiveness of dry needling for chronic nonspecific
neck pain: a randomized, single-blinded, clinical trial. Pain
2016;157: 1905-17.doi: 10.1097/j.pain.000.000.0000000591
Gallego-Sendarrubias GM, Rodríguez-Sanz D, Calvo-Lobo C,
et al. Efficacy of dry needling as an adjunct to manual therapy
for patients with chronic mechanical neck pain: a randomised
clinical trial. Acupunct Med 2020; acupmed-2018-011682.
doi: 10.1097/AJP.000.000.0000000634
Ziaeifar M, Arab AM, Mosallanezhad Z, et al. Dry needling
versus trigger point compression of the upper trapezius:
a randomized clinical trial with two-week and threemonth
follow-up. J Man Manip Ther 2019;27: 152-161.
doi: 10.1080/10669.817.2018.1530421
Kietrys DM, Palombaro KM, Azzaretto E, et al. Effectiveness
of dry needling for upper-quarter myofascial pain: a systematic
review and meta-analysis. J Orthop Sports Phys Ther 2013;43:
620-634. doi: 10.2519/jospt.2013.4668
Nunes AMP, Moita JPAM. Effectiveness of physical and
rehabilitation techniques in reducing pain in chronic
trapezius myalgia: A systematic review and meta-analysis.
Int J Osteopath Med 2015;18: 189-206.doi: 10.1016/j.
ijosm.2015.03.004
Fernández-de-las-Peñas C, Dommerholt J. Myofascial trigger
points: peripheral or central phenomenon? Curr Rheumatol
Rep 2014;16: 395.doi: 10.1007/s11926.013.0395-2
Navarro-Santana MJ, Sanchez-Infante J, Fernández-de-Las-
Peñas C, et al. Effectiveness of dry needling for myofascial
trigger points associated with neck pain symptoms: An
updated systematic review and meta-analysis. J Clin Med
2020;9: 3300. doi: 10.3390/jcm9103300
Shah JP, Thaker N, Heimur J, et al. Myofascial trigger points
then and now: a historical and scientific perspective. PM&R
2015:7: 746-61. doi: 10.1016/j.pmrj.2015.01.024
Climent JM, Kuan T-S, Fenollosa P, et al. Botulinum toxin
for the treatment of myofascial pain syndromes involving
the neck and back: a review from a clinical perspective.
Evid Based Complement Alternat Med 2013:2013.
doi: 10.1155/2013/381459
Shah JP, Danoff JV, Desai MJ, et al. Biochemicals associated
with pain and inflammation are elevated in sites near to and
remote from active myofascial trigger points. Arch Phys Med
Rehabil 2008;89: 16-23. doi: 10.1016/j.apmr.2007.10.018
Unverzagt C, Berglund K, Thomas J. Dry needling for
myofascial trigger point pain: a clinical commentary. Int J
Sports Phys Ther 2015;10: 402-18.
Fernández-de-Las-Peñas C, Nijs J. Trigger point dry needling
for the treatment of myofascial pain syndrome: current
perspectives within a pain neuroscience paradigm. J Pain Res
2019;12: 1899-1911. doi: 10.2147/JPR.S154728
Pecos-Martín D, Montañez-Aguilera FJ, Gallego-Izquierdo T,
et al. Effectiveness of dry needling on the lower trapezius in
patients with mechanical neck pain: a randomized controlled
trial. Arch Phys Med Rehabil 2015;96: 775-81. doi: 10.1016/j.
apmr.2014.12.016
Dommerholt J. Dry needling—peripheral and central
considerations. J Man Manip Ther 2011;19: 223-7.
doi: 10.1179/106698111X131.297.29552065
Dunning J, Butts R, Mourad F, et al. Dry needling:
a literature review with implications for clinical
practice guidelines. Phys Ther Rev 2014;19: 252-65.
doi: 10.1179/108331913X138.442.45102034
Tsai C-T, Hsieh L-F, Kuan T-S, et al. Remote effects of dry
needling on the irritability of the myofascial trigger point in
the upper trapezius muscle. Am J Phys Med Rehabil 2010;89:
133-40. doi: 10.1097/PHM.0b013e3181a5b1bc
Liu L, Huang Q-M, Liu Q-G, et al. Effectiveness of dry
needling for myofascial trigger points associated with neck
and shoulder pain: a systematic review and meta-analysis.
Arch Phys Med Rehabil 2015;96: 944-55. doi: 10.1016/j.
apmr.2014.12.015
Aslan E, Karaduman A, Yakut Y, et al. The cultural adaptation,
reliability and validity of neck disability index in patients with
neck pain: a Turkish version study. Spine 2008;33: E362-E365.
doi: 10.1097/BRS.0b013e31817144e1
Cleland JA, Fritz JM, Whitman JM, et al. The reliability
and construct validity of the Neck Disability Index and
patient specific functional scale in patients with cervical
radiculopathy. Spine 2006;31: 598-602. doi: 10.1097/01.
brs.000.020.1241.90914.22
Pool JJ, Ostelo RW, Hoving JL, et al. Minimal clinically
important change of the Neck Disability Index and the
Numerical Rating Scale for patients with neck pain. Spine
2007;32: 3047-51.doi: 10.1097/BRS.0b013e31815cf75b
Simons DG, Travell J, Simons LS. Myofascial pain and
dysfunction: the trigger point manual. Volume 1. Baltimore:
Williams and Wilkins, 1999.
Hong C-Z. Considerations and recommendations regarding
myofascial trigger point injection. J Musculoskelet Pain
1994;2: 29-59.doi: 10.1300/J094v02n01_03
Tekin L, Akarsu S, Durmuş O, et al. The effect of dry needling
in the treatment of myofascial pain syndrome: a randomized
double-blinded placebo-controlled trial. Clin Rheumatol
2013;32: 309-15.doi: 10.1007/s10067.012.2112-3
Onat SS, Polat CS, Bicer S, et al. Effect of dry needling injection
and kinesiotaping on pain and quality of life in patients with
mechanical neck pain. Pain physician 2019;22: 583-9.
Cagnie B, Castelein B, Pollie F, et al. Evidence for the use of
ischemic compression and dry needling in the management
of trigger points of the upper trapezius in patients with neck
pain: a systematic review. Am J Phys Med Rehabil 2015;94:
573-83.doi: 10.1097/PHM.000.000.0000000266
Cerezo-Téllez E, Torres-Lacomba M, Fuentes-Gallardo I,
et al. Effectiveness of dry needling for chronic nonspecific
neck pain: a randomized, single-blinded, clinical trial. Pain
2016;157: 1905-17.doi: 10.1097/j.pain.000.000.0000000591
Gallego-Sendarrubias GM, Rodríguez-Sanz D, Calvo-Lobo C,
et al. Efficacy of dry needling as an adjunct to manual therapy
for patients with chronic mechanical neck pain: a randomised
clinical trial. Acupunct Med 2020; acupmed-2018-011682.
doi: 10.1097/AJP.000.000.0000000634
Ziaeifar M, Arab AM, Mosallanezhad Z, et al. Dry needling
versus trigger point compression of the upper trapezius:
a randomized clinical trial with two-week and threemonth
follow-up. J Man Manip Ther 2019;27: 152-161.
doi: 10.1080/10669.817.2018.1530421
Kietrys DM, Palombaro KM, Azzaretto E, et al. Effectiveness
of dry needling for upper-quarter myofascial pain: a systematic
review and meta-analysis. J Orthop Sports Phys Ther 2013;43:
620-634. doi: 10.2519/jospt.2013.4668
Nunes AMP, Moita JPAM. Effectiveness of physical and
rehabilitation techniques in reducing pain in chronic
trapezius myalgia: A systematic review and meta-analysis.
Int J Osteopath Med 2015;18: 189-206.doi: 10.1016/j.
ijosm.2015.03.004
Fernández-de-las-Peñas C, Dommerholt J. Myofascial trigger
points: peripheral or central phenomenon? Curr Rheumatol
Rep 2014;16: 395.doi: 10.1007/s11926.013.0395-2
Sanal Toprak, C., & Ozsoy Unubol, T. (2021). Effectiveness of dry needling in the treatment of neck pain and disability associated with myofascial trigger points. Marmara Medical Journal, 34(1), 40-44. https://doi.org/10.5472/marumj.866557
AMA
Sanal Toprak C, Ozsoy Unubol T. Effectiveness of dry needling in the treatment of neck pain and disability associated with myofascial trigger points. Marmara Med J. January 2021;34(1):40-44. doi:10.5472/marumj.866557
Chicago
Sanal Toprak, Canan, and Tugba Ozsoy Unubol. “Effectiveness of Dry Needling in the Treatment of Neck Pain and Disability Associated With Myofascial Trigger Points”. Marmara Medical Journal 34, no. 1 (January 2021): 40-44. https://doi.org/10.5472/marumj.866557.
EndNote
Sanal Toprak C, Ozsoy Unubol T (January 1, 2021) Effectiveness of dry needling in the treatment of neck pain and disability associated with myofascial trigger points. Marmara Medical Journal 34 1 40–44.
IEEE
C. Sanal Toprak and T. Ozsoy Unubol, “Effectiveness of dry needling in the treatment of neck pain and disability associated with myofascial trigger points”, Marmara Med J, vol. 34, no. 1, pp. 40–44, 2021, doi: 10.5472/marumj.866557.
ISNAD
Sanal Toprak, Canan - Ozsoy Unubol, Tugba. “Effectiveness of Dry Needling in the Treatment of Neck Pain and Disability Associated With Myofascial Trigger Points”. Marmara Medical Journal 34/1 (January 2021), 40-44. https://doi.org/10.5472/marumj.866557.
JAMA
Sanal Toprak C, Ozsoy Unubol T. Effectiveness of dry needling in the treatment of neck pain and disability associated with myofascial trigger points. Marmara Med J. 2021;34:40–44.
MLA
Sanal Toprak, Canan and Tugba Ozsoy Unubol. “Effectiveness of Dry Needling in the Treatment of Neck Pain and Disability Associated With Myofascial Trigger Points”. Marmara Medical Journal, vol. 34, no. 1, 2021, pp. 40-44, doi:10.5472/marumj.866557.
Vancouver
Sanal Toprak C, Ozsoy Unubol T. Effectiveness of dry needling in the treatment of neck pain and disability associated with myofascial trigger points. Marmara Med J. 2021;34(1):40-4.